Individual
DONN MARSHALL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 GAIL GARDNER WAY, PRESCOTT, AZ 86305-1690
(928) 776-1040
(928) 776-1041
Mailing address
PO BOX 810221, DALLAS, TX 75381-0221
(520) 519-7700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
39768
CO
2085R0001X
Radiation Oncology Physician
Primary
58993
AZ
2085R0001X
Radiation Oncology Physician
G53197
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75206307
—
CO
01
—
920007066
RR MEDICARE
CO
Enumeration date
11/25/2005
Last updated
03/10/2022
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